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Econazole

Pronunciation

(e KONE a zole)

Index Terms

  • Econazole Nitrate
  • Ecoza
  • Spectazole

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Cream, External, as nitrate:

Generic: 1% (15 g, 30 g, 85 g)

Foam, External, as nitrate:

Ecoza: 1% (70 g) [contains propylene glycol, trolamine (triethanolamine)]

Brand Names: U.S.

  • Ecoza

Pharmacologic Category

  • Antifungal Agent, Imidazole Derivative
  • Antifungal Agent, Topical

Pharmacology

Alters fungal cell wall membrane permeability; may interfere with RNA and protein synthesis, and lipid metabolism

Absorption

Cream: <10%

Metabolism

Cream: Hepatic to more than 20 metabolites

Excretion

Cream: Urine (<1%); feces (<1%)

Time to Peak

Foam: 6.8 ± 5.1 hours

Use: Labeled Indications

Fungal infection:

Cream: Treatment of tinea pedis, tinea cruris, and tinea corporis caused by Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, Microsporum canis, Microsporum audouini, Microsporum gypseum, and Epidermophyton floccosum in the treatment of cutaneous candidiasis, and in the treatment of tinea versicolor.

Foam: Treatment of interdigital tinea pedis caused by Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum in patients 12 years and older

Contraindications

Cream: Hypersensitivity to econazole or any component of the formulation

Foam: There are no contraindications listed in the manufacturer’s labeling. Documentation of allergenic cross-reactivity for imidazole antifungals is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.

Dosing: Adult

Tinea pedis: Topical: Cream, Foam: Apply sufficient amount to cover affected areas once daily for 4 weeks

Tinea cruris, tinea corporis, tinea versicolor: Topical: Cream: Apply sufficient amount to cover affected areas once daily for 2 weeks

Cutaneous candidiasis: Topical: Cream: Apply sufficient quantity twice daily (morning and evening) for 2 weeks

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Tinea pedis: Children ≥12 years and Adolescents: Topical: Foam: Apply sufficient amount to cover affected area once daily for 4 weeks

Administration

Occasionally, longer treatment periods may be required. For external use only. Not for oral, ophthalmic, or vaginal use. Avoid contact with the eyes.

Storage

Cream: Store below 30°C (86°F).

Foam: Store at 20°C to 25°C (68°F to 77°F); excursions are permitted between 15°C and 30°C (59°F and 86°F). Do not expose to heat and/or store at temperatures >49°C (120°F) even when the container is empty. Do not store in direct sunlight. Do not refrigerate or freeze.

Drug Interactions

Vitamin K Antagonists (eg, warfarin): Econazole may increase the serum concentration of Vitamin K Antagonists. Monitor therapy

Adverse Reactions

1% to 10%: Dermatologic: Burning sensation of skin (3%), erythema (3%), pruritus (3%), stinging of the skin (3%)

<1% (Limited to important or life-threatening): Application site reaction, pruritic rash

Warnings/Precautions

Concerns related to adverse effects:

• Irritation: Discontinue if sensitivity or irritation occurs.

Dosage form specific issues:

• Foam: Avoid heat, flame, and smoking during and immediately following application; topical foam is flammable.

Other warnings/precautions:

• Appropriate use: For topical use only; avoid contact with eyes, mouth, nose, or other mucous membranes

Monitoring Parameters

Reassess diagnosis if no clinical improvement after 2 weeks.

Pregnancy Risk Factor

C

Pregnancy Considerations

Adverse events were observed in some animal reproduction studies. The manufacturer recommends avoiding use during pregnancy, especially during the first trimester.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Have patient report immediately to prescriber severe skin irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

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